Impact of benign prostatic hyperplasia pharmacological treatment on transrectal prostate biopsy adverse effects

Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients were questioned about symptoms lasting over a week and classified according to pharmacological BPH treatment. Results. Thirty-three patients (17%) were using alpha-blocker exclusively, five (3%) 5-alpha-reductase inhibitor exclusively, twelve (6%) patients used both medications, and 140 (74%) patients used none. There was no difference in regard to age among groups (P = 0.5). Postbiopsy adverse effects occurred as follows: hematuria 96 (50%), hematospermia 53 (28%), hematochezia 22 (12%), urethrorrhagia 19 (10%), fever 5 (3%), and pain 20 (10%). There was a significant negative correlation between postbiopsy hematuria and BPH pharmacological treatment with stronger correlation for combined use of 5-alpha-reductase inhibitor and alpha-blocker over 6 months (P = 0.0027). Conclusion. BPH pharmacological treatment, mainly combined for at least 6 months seems to protect against prostate biopsy adverse effects. Future studies are necessary to confirm our novel results. © 2014 Marina Zamuner et al.Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Amongsem informaçãosem informação(2013) Overview: Prostate Cancer. How Many Men Get Prostate Cancer?, , http://www.cancer.org/acs/groups/cid/documents/webcontent/003072-pdf.pdfRabbani, F., Stroumbakis, N., Kava, B.R., Cookson, M.S., Fair, W.R., Incidence and clinical significance of false-negative sextant prostate biopsies (1998) Urologe - Ausgabe A, 37 (6), p. 660Thompson, I.M., Pauler, D.K., Goodman, P.J., Tangen, C.M., Lucia, M.S., Parnes, H.L., Minasian, L.M., Coltman Jr., C.A., Prevalence of prostate cancer among men with a prostate-specific antigen level ≤4.0 ng per milliliter (2004) New England Journal of Medicine, 350 (22), pp. 2239-2246+2321. , DOI 10.1056/NEJMoa031918Ahrens, M.J., Bertin, P.A., Vonesh, E.F., Meade, T.J., Catalona, W.J., Georganopoulou, D., PSA enzymatic activity: A new biomarker for assessing prostate cancer aggressiveness (2013) Prostate, 73 (16), pp. 1731-1737. , 10.1002/pros.22714Rifkin, M.D., Alexander, A.A., Pisarchick, J., Matteucci, T., Palpable masses in the prostate: Superior accuracy of US-guided biopsy compared with accuracy of digitally guided biopsy (1991) Radiology, 179 (1), pp. 41-42. , 2-s2.0-0025969342Loeb, S., Vellekoop, A., Ahmed, H.U., Catto, J., Emberton, M., Nam, R., Rosario, D.J., Lotan, Y., Systematic review of complications of prostate biopsy (2013) European Urology, 64 (6), pp. 876-892. , 10.1016/j.eururo.2013.05.049Shen, P.-F., Zhu, Y.-C., Wei, W.-R., Li, Y.-Z., Yang, J., Li, Y.-T., Li, D.-M., Zeng, H., The results of transperineal versus transrectal prostate biopsy: A systematic review and meta-analysis (2012) Asian Journal of Andrology, 14 (2), pp. 310-315. , 2-s2.0-84858059084 10.1038/aja.2011.130Kravchick, S., Cytron, S., Mamonov, A., Peled, R., Linov, L., Effect of short-term dutasteride therapy on prostate vascularity in patients with benign prostatic hyperplasia: A pilot study (2009) Urology, 73 (6), pp. 1274-1278. , 2-s2.0-67349198057 10.1016/j.urology.2008.08.461Liao, C.-H., Guh, J.-H., Chueh, S.-C., Yu, H.-J., Anti-angiogenic effects and mechanism of prazosin (2011) Prostate, 71 (9), pp. 976-984. , 2-s2.0-79955575350 10.1002/pros.21313Keledjian, K., Borkowski, A., Kim, G., Isaacs, J.T., Jacobs, S.C., Kyprianou, N., Reduction of human prostate tumor vascularity by the α1- adrenoceptor antagonist terazosin (2001) Prostate, 48 (2), pp. 71-78. , DOI 10.1002/pros.1083Angulo, J., Cuevas, P., Fernández, A., La Fuente, J.M., Allona, A., Moncada, I., De Tejada, I.S., Tadalafil enhances the inhibitory effects of tamsulosin on neurogenic contractions of human prostate and bladder neck (2012) The Journal of Sexual Medicine, 9 (9), pp. 2293-2306. , 10.1111/j.1743-6109.2012.02821.xReis, L.O., Zani, E.L., Alonso, J.C., Simões, F.A., Rejowski, R.F., Ferreira, U., Does the criterion for prostate biopsy indication impact its accuracy? A prospective population-based outpatient clinical setting study (2011) Actas Urologicas Espanolas, 35 (1), pp. 10-14. , 2-s2.0-79151485525 10.1016/j.acuro.2010.06.011Junqueira, V.C.N., Zogbi, O., Cologna, A., Dos Reis, R.B., Tucci, Jr.S., Reis, L.O., Westphalen, A.C., Muglia, V.F., Is a visible (hypoechoic) lesion at biopsy an independent predictor of prostate cancer outcome? (2012) Ultrasound in Medicine and Biology, 38 (10), pp. 1689-1694. , 10.1016/j.ultrasmedbio.2012.06.006Reis, L.O., Reinato, J.A.S., Silva, D.C., Matheus, W.E., Denardi, F., Ferreira, U., The impact of core biopsy fragmentation in prostate cancer (2010) International Urology and Nephrology, 42 (4), pp. 965-969. , 2-s2.0-78751646334 10.1007/s11255-010-9720-0Anastasiadis, A., Zapała, L., Cordeiro, E., Antoniewicz, A., Dimitriadis, G., De Reijke, T., Complications of prostate biopsy (2013) Expert Review of Anticancer Therapy, 13 (7), pp. 829-837. , 10.1586/14737140.2013.811056Campeggi, A., Ouzaid, I., Xylinas, E., Lesprit, P., Hoznek, A., Vordos, D., Abbou, C.C., De La Taille, A., Acute bacterial prostatitis after transrectal ultrasound-guided prostate biopsy: Epidemiological, bacteria and treatment patterns from a 4-year prospective study (2013) International Journal of Urology, 21 (2), pp. 152-155. , 10.1111/iju.12207Pinkhasov, G.I., Lin, Y.-K., Palmerola, R., Smith, P., Mahon, F., Kaag, M.G., Dagen, J.E., Raman, J.D., Complications following prostate needle biopsy requiring hospital admission or emergency department visits - Experience from 1000 consecutive cases (2012) BJU International, 110, pp. 369-374. , 2-s2.0-84856569661 10.1111/j.1464-410X.2011.10926.xPeyromaure, M., Ravery, V., Messas, A., Toublanc, M., Boccon-Gibod, L., Boccon-Gibod, L., Pain and morbidity of an extensive prostate 10-biopsy protocol: A prospective study in 289 patients (2002) Journal of Urology, 167 (1), pp. 218-221Ozdal, O.L., Ozden, C., Benli, K., Gokkaya, S., Bulut, S., Memis, A., Effect of short-term finasteride therapy on peroperative bleeding in patients who were candidates for transurethral resection of the prostate (TUR-P): A randomized controlled study (2005) Prostate Cancer and Prostatic Diseases, 8 (3), pp. 215-218. , DOI 10.1038/sj.pcan.4500818, PII 4500818Pastore, A.L., Mariani, S., Barrese, F., Palleschi, G., Valentini, A.M., Pacini, L., Petrozza, V., Cappa, M., Transurethral resection of prostate and the role of pharmacological treatment with dutasteride in decreasing surgical blood loss (2013) Journal of Endourology, 27 (1), pp. 68-70. , 10.1089/end.2012.0231Hahn, R.G., Fagerström, T., Tammela, T.L.J., Van Vierssen Trip, O., Beisland, H.O., Duggan, A., Morrill, B., Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride (2007) BJU International, 99 (3), pp. 587-594. , 2-s2.0-33846934500 10.1111/j.1464-410X.2006.06619.xArratia-Maqueo, J.A., Garza-Cortés, R., Gómez-Guerra, L.S., Cortés-Gonzlez, J.R., Effect of one month treatment with dutasteride on transurethral resection of the prostate (2010) Actas Urologicas Espanolas, 34 (10), pp. 866-869. , 2-s2.0-78049478337 10.1016/j.acuro.2010.06.00

Prevalence of cardiovascular risk factors, the association with socioeconomic variables in adolescents from Low-Income region

Objectives: To estimate the prevalence of obesity, overweight, abdominal obesity and high blood pressure in a sample of adolescents from a low-income city in Brazil and to estimate the relationship with the socioeconomic status of the family, the education level of the family provider and the type of school. Methods: This cross-sectional study randomly sampled 1,014 adolescents (54.8% girls), between 14-19 years of age, attending high school from Imperatriz (MA). The outcomes of this study were: obesity and overweight, abdominal obesity and high blood pressure (systolic and/ or diastolic). The independent variables were: socioeconomic status (SES) of the family, education level of the family provider (ELFP) and type of school. The confounding variables were: gender, age and physical activity level. Prevalence was estimated, and the association between the endpoints and the independent variables was analyzed using a prevalence ratio (PR), with a 95% confidence interval, estimated by Poisson regression. Results: The overall prevalence of obesity was 3.8%, overweight, 13.1%, abdominal obesity, 22.7% and high blood pressure, 21.3%. The adjusted analysis indicated that girls with high SES showed an increased likelihood to be overweight (PR=1.71 [95% IC: 1.13-2.87]), while private school boys had an increased likelihood of obesity (PR=1.79 [95% CI: 1.04-3.08]) and abdominal obesity (PR =1.64 [95% CI: 1.06-2.54]). Conclusion: The prevalence of CVDR is high in adolescents from this low-income region. Boys from private schools are more likely to have obesity and abdominal obesity, and girls with high SES are more likely to be overweight

The four dimensional site-diluted Ising model: a finite-size scaling study

Using finite-size scaling techniques, we study the critical properties of the site-diluted Ising model in four dimensions. We carry out a high statistics Monte Carlo simulation for several values of the dilution. The results support the perturbative scenario: there is only the Ising fixed point with large logarithmic scaling corrections. We obtain, using the Perturbative Renormalization Group, functional forms for the scaling of several observables that are in agreement with the numerical data.Comment: 30 pages, 8 postscript figure

Search for Λc+→pK+π−\Lambda_c^+ \to p K^+ \pi^- and Ds+→K+K+π−D_s^+ \to K^+ K^+ \pi^- Using Genetic Programming Event Selection

We apply a genetic programming technique to search for the double Cabibbo suppressed decays $\Lambda_c^+ \to p K^+ \pi^-$ and $D_s^+ \to K^+ K^+ \pi^-$. We normalize these decays to their Cabibbo favored partners and find $\text{BR}($\Lambda_c^+ \to p K^+ \pi^-$)/\text{BR}($\Lambda_c^+ \to p K^- \pi^+$) = (0.05 \pm 0.26 \pm 0.02)$ and $\text{BR}($D_s^+ \to K^+ K^+ \pi^-$)/\text{BR}($D_s^+ \to K^+ K^- \pi^+$) = (0.52\pm 0.17\pm 0.11)$ where the first errors are statistical and the second are systematic. Expressed as 90% confidence levels (CL), we find $< 0.46$ and $< 0.78$ respectively. This is the first successful use of genetic programming in a high energy physics data analysis.Comment: 10 page

Measurement of the D+ and Ds+ decays into K+K-K+

We present the first clear observation of the doubly Cabibbo suppressed decay D+ --> K-K+K+ and the first observation of the singly Cabibbo suppressed decay Ds+ --> K-K+K+. These signals have been obtained by analyzing the high statistics sample of photoproduced charm particles of the FOCUS(E831) experiment at Fermilab. We measure the following relative branching ratios: Gamma(D+ --> K-K+K+)/Gamma(D+ --> K-pi+pi+) = (9.49 +/- 2.17(statistical) +/- 0.22(systematic))x10^-4 and Gamma(Ds+ --> K-K+K+)/Gamma(Ds+ --> K-K+pi+) = (8.95 +/- 2.12(statistical) +2.24(syst.) -2.31(syst.))x10^-3.Comment: 10 pages, 8 figure

A Non-parametric Approach to the D+ to K*0bar mu+ nu Form Factors

Using a large sample of D+ -> K- pi+ mu+ nu decays collected by the FOCUS photoproduction experiment at Fermilab, we present the first measurements of the helicity basis form factors free from the assumption of spectroscopic pole dominance. We also present the first information on the form factor that controls the s-wave interference discussed in a previous paper by the FOCUS collaboration. We find reasonable agreement with the usual assumption of spectroscopic pole dominance and measured form factor ratios.Comment: 14 pages, 5 figures, and 2 tables. We updated the previous version by changing some words, removing one plot, and adding two tables. These changes are mostly stylisti

Measurements of Ξc+\Xi_c^{+} Branching Ratios

Using data collected by the fixed target Fermilab experiment FOCUS, we measure the branching ratios of the Cabibbo favored decays $\Xi_c^+ \to \Sigma^+K^-\pi^+$, $\Xi_c^+ \to \Sigma^+ \bar{K}^{*}(892)^0$, and $\Xi_c^+ \to \Lambda^0K^-\pi^+\pi^+$ relative to $\Xi_c^+ \to \Xi^-\pi^+\pi^+$ to be $0.91\pm0.11\pm0.04$, $0.78\pm0.16\pm0.06$, and $0.28\pm0.06\pm0.06$, respectively. We report the first observation of the Cabibbo suppressed decay $\Xi_c^+ \to \Sigma^+K^+K^-$ and we measure the branching ratio relative to $\Xi_c^+ \to \Sigma^+K^-\pi^+$ to be $0.16\pm0.06\pm0.01$. We also set 90% confidence level upper limits for $\Xi_c^+ \to \Sigma^+ \phi$ and $\Xi_c^+ \to \Xi^*(1690)^0(\Sigma^+ K^-) K^+$ relative to $\Xi_c^+ \to \Sigma^+K^-\pi^+$ to be 0.12 and 0.05, respectively. We find an indication of the decays $\Xi_c^+ \to \Omega^-K^{+}\pi^+$ and $\Xi_c^+ \to \Sigma^{*}(1385)^+ \bar{K}^0$ and set 90% confidence level upper limits for the branching ratios with respect to $\Xi_c^+ \to \Xi^-\pi^+\pi^+$ to be 0.12 and 1.72, respectively. Finally, we determine the 90% C.L. upper limit for the resonant contribution $\Xi_c^+ \to \Xi^{*}(1530)^0 \pi^+$ relative to $\Xi_c^+ \to \Xi^-\pi^+\pi^+$ to be 0.10.Comment: 14 pages, 8 figure